Breast infections in non lactating women are not common but when they
present they need a good work up.  The one case I saw was in an older
patient who had developed diabetes; a florid unilateral mastitis was the
presenting symptom.

I also did a literature search about one year ago.  I found the following
tidbits:

Patients are at an increased risk for developing non lactational mastitis
and abscesses if they are diabetic, have a mammary fistula present or have
had previous infections.

The organisms can be varied but are primarily staph with a variety of
anaerobic bacteria.  Primary Gram negative breast infection is very uncommon
and these patients probably need a very thorough neoplastic workup including
open biopsy. TB was reported in an abscess of a patient who was HIV
positive.

Breast abscesses can often be treated with repeated aspirations in an
out-patient setting.  Cytology on aspirated abscess fluid and mammograms
were negative in two of two patients who were diagnosed as cancer on open
biopsy.

Ferrara JJ, Leveque J, et al.  Nonsurgical management of breast infection in
nonlactating women; a word a caution.  The American Surgeon 1990; 56:668-71
Dixon JM.  Outpatient treatment of non-lactational breast abscesses.  Br. J.
Surg 1992; 79:56-7
Hartstein M and Leaf H.  Tuberculosis of the breast as a presenting
manifestation of AIDS.  Clin Inf Dis 1992; 15:692-3

From the Snowy North,

Shirley Gross M.D.,C.M.
Director, Edmonton Breastfeeding Clinic